Robert Wood Johnson University Hospital

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1 Robert Wood Johnson University Hospital Financial Statements

2 Table of Contents Page Independent Auditors Report 1 Financial Statements Balance Sheet 3 Statement of Operations 5 Statement of Changes in Net Assets 6 Statement of Cash Flows 7 8 Supplementary Information Combining Balance Sheet, December 31, Combining Statement of Operations, Year Ended December 31, Combining Statement of Changes in Net Assets, Year Ended December 31,

3 Baker Tilly Virchow Krause, LLP 100 Walnut Ave, Ste 200 Clark, NJ tel tel fax bakertilly.com Independent Auditors Report Board of Directors Robert Wood Johnson University Hospital Report on the Financial Statements We have audited the accompanying financial statements of Robert Wood Johnson University Hospital (the Hospital ), which comprise the balance sheet as of, and the related statements of operations, changes in net assets, and cash flows for the years then ended, and the related notes to the financial statements. Management s Responsibility for the Financial Statements Management is responsible for the preparation and fair presentation of these financial statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation, and maintenance of internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error. Auditors Responsibility Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free from material misstatement. An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditor s judgment, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity s preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity s internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion. 1 An Affirmative Action Equal Opportunity Employer

4 Opinion In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Robert Wood Johnson University Hospital as of, and the results of their operations and their cash flows for the years then ended in accordance with accounting principles generally accepted in the United States of America. Emphasis of Matter As noted in Note 1 to the financial statements, Robert Wood Johnson University Hospital and Somerset Medical Center agreed to merge operations on June 1, Our opinion is not modified with respect to this matter. Report on Supplementary Information Our audits were conducted for the purpose of forming an opinion on the financial statements as a whole. The supplementary information presented on pages 48 through 51 is presented for purposes of additional analysis rather than to present the financial position, results of operations or changes in net assets of the individual companies and is not a required part of the financial statements. Such information is the responsibility of management and was derived from and relates directly to the underlying accounting and other records used to prepare the financial statements. The information has been subjected to the auditing procedures applied in the audits of the financial statements and certain additional procedures, including comparing and reconciling such information directly to the underlying accounting and other records used to prepare the financial statements or to the financial statements themselves, and other additional procedures in accordance with auditing standards generally accepted in the United States of America. In our opinion, the information is fairly stated in all material respects in relation to the financial statements as a whole. Clark, New Jersey April 13,

5 Balance Sheet (In thousands) Assets Current Assets Cash and cash equivalents $ 56,008 $ 35,110 Investments 2,796 2,465 Assets limited or restricted as to use, required for current obligations 8,407 6,288 Accounts receivable: Patient (net of estimated allowance for doubtful collections of $67,045 in 2014 and $59,862 in 2013) 142, ,960 Other (net of estimated allowance for doubtful collections of $2,333 in 2014 and $6,439 in 2013) 1,509 2,638 Due from related parties, net 9,497 12,315 Other current assets 42,764 26,152 Total current assets 263, ,928 Assets Limited or Restricted as to Use Board-designated 614, ,336 Held by trustee and self-insurance 167, ,125 Total assets limited or restricted as to use 781, ,461 Less amounts required to meet current obligations 8,407 6, , ,173 Property and Equipment, Net 537, ,500 Long-Term Restricted Investments 2,487 2,386 Interest in Net Assets of Foundations 54,379 49,009 Due from Related Parties 25,585 12,000 Other Noncurrent Assets, Net 12,859 23,337 Total assets $ 1,669,675 $ 1,400,333 See notes to financial statements 3

6 Balance Sheet (In thousands) Liabilities and Net Assets Current Liabilities Current installments of long-term debt $ 7,773 $ 7,538 Accounts payable 96,276 69,198 Accrued expenses 94,156 63,675 Accrued bond interest payable 6,466 4,523 Estimated third-party payor settlements 15,566 22,230 Total current liabilities 220, ,164 Long-Term Liabilities Estimated third-party payor settlements, excluding current portion 29,858 26,905 Other long-term liabilities 68,364 17,266 Long-term debt, excluding current installments 428, ,596 Total liabilities 746, ,931 Net Assets Unrestricted 882, ,146 Temporarily restricted 35,920 30,561 Permanently restricted 4,174 2,695 Total net assets 922, ,402 Total liabilities and net assets $ 1,669,675 $ 1,400,333 See notes to financial statements 4

7 Statement of Operations Years Ended (In thousands) Unrestricted Revenues and Other Support Patient service revenues, net of contractual allowances and discounts $ 1,062,971 $ 860,658 Less provision for doubtful collections 51,085 51,446 Net patient service revenues 1,011, ,212 Other revenues 23,137 22,752 Net assets released from restrictions for operations 7,747 7,034 Total unrestricted revenues and other support 1,042, ,998 Expenses Salaries and wages, and contracted labor 386, ,648 Employee benefits 92,745 70,651 Physician fees 59,534 54,086 Supplies and expenses 417, ,399 Depreciation and amortization 52,464 41,077 Interest 9,707 6,503 Total expenses 1,017, ,364 Operating income 25,186 26,634 Nonoperating Activities Investment return, net 11,885 77,205 Change in unrestricted net assets of RWJ University Hospital Foundation, Inc. 464 (663) Inherent contribution of Somerset Medical Center 83,157 - Provision for doubtful RWJ Physician Enterprise, PA and related-party collections (39,436) - Other gains, net Revenues in excess of expenses 81, ,302 Transfers to affiliates - (2,515) Net assets released from restrictions for capital purchases Pension liability adjustment (13,160) - Change in net unrealized gains and losses on investments, other than trading 2,014 6,165 Increase in unrestricted net assets $ 71,585 $ 107,926 See notes to financial statements 5

8 Statement of Changes in Net Assets Years Ended (In thousands) Unrestricted Net Assets Revenues in excess of expenses $ 81,997 $ 103,302 Transfers to affiliates - (2,515) Net assets released from restrictions for capital purchases Pension liability adjustment (13,160) - Change in net unrealized gains and losses on investments, other than trading 2,014 6,165 Increase in unrestricted net assets 71, ,926 Temporarily Restricted Net Assets Contributions, gifts, grants, and bequests 1, Inherent contribution of Somerset Medical Center 1,781 - Interest income Change in unrealized gains on investments 31 (54) Net assets released from restrictions used for operations (7,747) (7,034) Net assets released from restrictions for capital purchases (734) (974) Change in net assets of Foundations 10,314 8,673 Increase in temporarily restricted net assets 5, Permanently Restricted Net Assets Inherent contribution of Somerset Medical Center 1,140 - Change in net assets of RWJ University Hospital Foundation, Inc Increase in permanently restricted net assets 1, Increase in net assets 78, ,847 Net Assets, Beginning 844, ,555 Net Assets, Ending $ 922,825 $ 844,402 See notes to financial statements 6

9 Statement of Cash Flows Years Ended (In thousands) Cash Flows from Operating Activities Increase in net assets $ 78,423 $ 108,847 Adjustments to reconcile increase in net assets to net cash provided by operating activities: Depreciation and amortization 52,464 41,077 Amortization/accretion of bond discount/premium (297) 143 Change in net unrealized gains and losses on trading and other than trading investments 12,534 (47,218) Realized gain on sale of securities, net (18,590) (29,642) Provision for doubtful collections 51,085 51,446 Provision for doubtful RWJ Physician Enterprise, PA and related-party collections 39,436 - Transfers to affiliates - 2,515 Change in interest in net assets of Foundations (1,690) (4,420) Inherent contribution of Somerset Medical Center (86,078) - Changes in assets and liabilities: Increase in patient accounts receivable (58,941) (54,228) Increase in other receivables, due from related parties, and other current assets (17,538) (12,294) Increase in accounts payable, accrued expenses, and accrued bond interest payable 39,917 27,750 Decrease in estimated third-party payor settlements (3,711) (7,018) (Decrease) increase in other long-term liabilities (6,700) 586 Net cash provided by operating activities 80,314 77,544 Cash Flows from Investing Activities Purchase of property, plant and equipment (94,550) (55,296) Purchase of investments and assets limited or restricted as to use (172,694) (486,967) Proceeds from sale of investments and assets limited or restricted as to use 238, ,391 Cash acquired in affiliation with Somerset Medical Center 6,773 - Increase in long-term restricted investments (101) (46) Decrease (increase) in other noncurrent assets (28,958) (15,496) Net cash provided by (used in) investing activities (51,459) (268,414) Cash Flows from Financing Activities Proceeds from issuance of long-term debt 91, ,934 Payment of short-term debt for Somerset Medical Center (92,284) - Payment of financing costs (763) 608 Repayment of long-term debts (6,267) (7,166) Repayment of capital lease obligations (508) (1,564) Transfers to affiliates - (2,515) Net cash (used in) provided by financing activities (7,957) 169,297 Increase (decrease) in cash and cash equivalents 20,898 (21,573) Cash and Cash Equivalents, Beginning 35,110 56,683 Cash and Cash Equivalents, Ending $ 56,008 $ 35,110 Supplemental Disclosure of Cash Flow Information, Cash paid for interest $ 7,639 $ 4,864 See notes to financial statements 7

10 1. Organization and Summary of Significant Accounting Policies Robert Wood Johnson University Hospital (the Hospital ), the principal teaching hospital for Rutgers, the State University of New Jersey ("Rutgers"), is a nonprofit health care institution. Robert Wood Johnson Health Care Corporation ( RWJHCC ) is the sole member of the Hospital. Effective June 1, 2014, Somerset Medical Center ( Somerset ) was merged into the Hospital which created a 965-bed hospital with campuses in New Brunswick and Somerville. As part of the merger, Somerset dissolved as of June 1, 2014, and transferred its assets to the Hospital and the Hospital became the sole member and/or parent corporation of Somerset. As a result of the actions taken, this transaction is considered to be an acquisition under accounting principles generally accepted in the United States of America. The Hospital did not transfer any consideration as part of this transaction and the net assets acquired by the Hospital have been recognized as inherent contributions in the statement of operations and changes in net assets (Note 3). A formal relationship between the Hospital and the University of Medicine and Dentistry of New Jersey ("UMDNJ") was initiated in 1977, when the Hospital and UMDNJ entered into an affiliation agreement which established the Hospital as the primary teaching hospital for the Robert Wood Johnson Medical School Division of UMDNJ. A new affiliation agreement was entered into on February 8, In 1998, UMDNJ formally acknowledged the Hospital as the principal teaching hospital for the Robert Wood Johnson Medical School. Principal hospital designation indicates the highest level of relationship bestowed by UMDNJ to a non owned hospital. Effective July 1, 2013, the Hospital's agreement with UMDNJ transferred to Rutgers. This transition comes as a result of the enactment of the New Jersey Medical and Health Sciences Education Restructuring Act which transferred the majority of schools and institutes under UMDNJ, as well as underlying agreements, to Rutgers. The following items comprise the significant accounting policies which are followed by the Hospital: Use of Estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. 8

11 Cash Equivalents Cash equivalents include certain investments in highly liquid debt instruments with original maturities of three months or less and money market funds. The carrying amount of cash equivalents approximates fair value because of the short-term maturity of those instruments, and may include investments in certificates of deposit, commercial paper, repurchase agreements, or highly liquid U.S. Government, and agency obligations. The Hospital has balances with financial institutions that exceed federal depository insurance limits. Management does not believe the credit risk related to these deposits to be significant. Patient Accounts Receivable Patient accounts receivable are reported at net realizable value. Accounts are written off when they are determined to be uncollectible based upon management s assessment of individual accounts. In evaluating the collectibility of patient accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue. For receivables associated with services provided to patients who have third-party coverage (which includes patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital analyzes contractual amounts due and provides an allowance for doubtful collections and a provision for doubtful collections, if necessary. For receivables associated with self-pay patients (which includes both patients without insurance and insured patients with deductible and copayment balances), the Hospital records a significant provision for doubtful collections in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful collections. The Hospital s allowance for doubtful collections for self-pay patients was 71% and 76% of self-pay accounts receivable at December 31, 2014 and December 31, 2013, respectively. In addition, the Hospital s self-pay account write-offs (net of recoveries) increased to $56,844 in 2014 from $49,432 in The increase was the result of increases in self-pay volume due to the Somerset merger in The Hospital has not changed its financial assistance policy in 2014 or

12 Net Patient Service Revenue The Hospital has agreements with third-party payors that provide for payments to the Hospital at amounts different from its established rates. Payment arrangements include prospectively determined rates per discharge, reimbursed costs, discounted charges, per diem payments, and contracted amounts. The Hospital recognizes patient service revenue associated with services provided to patients who have third-party payor coverage on the basis of these established rates for the services rendered. For uninsured patients that do not qualify for charity care, the Hospital recognizes revenues on the basis of its standard rates, discounted in accordance with the Hospital s policy. On the basis of historical experience, a significant portion of the Hospital s uninsured patients will be unable or unwilling to pay for the services provided. Thus, the Hospital records a significant provision of bad debts related to uninsured patients in the period the services are provided. Patient service revenues, net of contractual allowances and discounts (but before the provision of bad debts), recognized in 2014 and 2013 from these major payor sources, are as follows: Third-Party Government Payors December 31, 2014 Third-Party Commercial Payors Self-Pay Total Patient service revenues (net of contractual allowances and discounts) $ 371,832 $ 686,816 $ 4,323 $ 1,062,971 December 31, 2013 Patient service revenues (net of contractual allowances and discounts) $ 294,388 $ 564,123 $ 2,147 $ 860,658 Investments and Investment Risks Investments in equity securities with readily determinable fair values and all investments in debt securities are measured at fair value in the balance sheet and are considered trading securities. Investments in alternative investments, which include real estate investments, are recorded at fair value based upon net asset values provided by external investment managers, which are reviewed and evaluated by Hospital management for reasonableness. These estimated fair values of alternative investments may differ significantly from the values that would have been used had a ready market for these investments existed. Alternative investments are considered other than trading securities. Unrealized gains and losses on investments are excluded from the determination of revenues in excess of expenses unless the investments are trading securities. Donorrestricted investment income is reported as an increase in temporarily restricted net assets. 10

13 The Hospital s investments are comprised of a variety of financial instruments and are managed by investment advisors. The fair values reported in the balance sheet are exposed to various risks including changes in the equity markets, the interest rate environment and general economic conditions. Due to the level of risk associated with certain investment securities and the level of uncertainty related to changes in the fair value of investment securities, it is reasonably possible that the amounts reported in the accompanying financial statements could change materially in the near term. Fair Value of Financial Instruments Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. The following methods and assumptions were used by the Hospital in estimating the fair value of its financial instruments: Cash Equivalents The carrying amounts reported in the balance sheet for cash equivalents approximate fair value. Investments Fair values, which are the amounts reported in the balance sheet, are based on quoted market prices, if available, or are estimated using quoted market prices for similar securities. Assets Limited or Restricted as to Use Fair values, which are the amounts reported in the balance sheet, are based on quoted market prices, if available, or are estimated using quoted market prices for similar securities. Long-Term Debt Fair values of the Hospital s Revenue Bonds are based on current traded values of the respective bonds. Other Current Assets Other current assets includes inventories which are stated at cost, which approximates market and is determined principally using an average cost method, using the FIFO (first-in, first-out) method. 11

14 Assets Limited or Restricted as to Use Assets limited or restricted as to use include assets held by trustees under indenture and self-insurance agreements and assets set aside by the board of directors for designated purposes over which the board of directors retains control and may at its discretion subsequently use for other purposes. Amounts available to meet current liabilities of the Hospital have been reclassified as current assets in the accompanying balance sheet. Assets limited or restricted as to use consist of equities, mutual funds, US Government and agency obligations, fixed income securities, mortgage and asset backed securities, real estate investments, partnerships, corporate bonds, hedged equity funds and other investments and are carried at fair value. Property and Equipment Property and equipment acquisitions are recorded at cost. Depreciation is provided over the estimated useful life of each class of depreciable asset and is computed using the straight line method (ranging from 3 to 40 years). Equipment under capital lease obligations is amortized on the straight line method over the shorter period of the lease term or the estimated useful life of the equipment. Such amortization is included in depreciation and amortization in the financial statements. Interest cost incurred on borrowed funds during the period of construction of capital assets is capitalized as a component of the cost of acquiring those assets. Gifts of long-lived assets such as land, buildings, or equipment are reported as unrestricted support, and are excluded from the revenues in excess of expenses, unless explicit donor stipulations specify how the donated assets must be used. Gifts of long-lived assets with explicit restrictions that specify how the assets are to be used and gifts of cash or other assets that must be used to acquire long-lived assets are reported as restricted support. Absent explicit donor stipulations about how long those long-lived assets must be maintained, expirations of donor restrictions are reported when the donated or acquired long-lived assets are placed in service. Impairment of Long-Lived Assets The Hospital reviews long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset. If the carrying amount of an asset exceeds its estimated future cash flows, an impairment charge is recognized by the amount by which the carrying amount of the asset exceeds the fair value of the asset. Assets to be disposed of are reported at the lower of the carrying amount or fair value, less costs to sell. Interest in Net Assets of Foundations The RWJ University Hospital Foundation, Inc. ("RWJ Foundation") and Somerset Medical Center Foundation (collectively, the Foundations ) are nonprofit organizations which were formed to raise, hold, and invest assets on behalf of the Hospital and Somerset. The Hospital recognizes its rights to the assets held by the Foundations when the Foundations raise or hold contributions on behalf of the Hospital. RWJHCC is the sole member of the RWJ Foundation. 12

15 Deferred Bond Financing Costs Deferred bond financing costs (which are included in other noncurrent assets) are amortized over the period in which the obligation is outstanding using the effective interest method. The costs include legal, financing, and placement fees associated with the issuance of longterm debt. During 2014, costs associated with the issuance of long-term debt of $763 were deferred. Accumulated amortization of deferred financing costs at December 31, 2014 and 2013 totaled $978 and $820, respectively. Self-Insured Benefits The Hospital is self-insured for the majority of employee medical and worker s compensation benefits. The provision for estimated employee medical benefits and worker s compensation claims includes estimates of the ultimate costs for both reported claims and claims incurred but not reported and is included in accrued expenses in the accompanying balance sheet. Temporarily and Permanently Restricted Net Assets Temporarily restricted net assets are those whose use by the Hospital has been limited by donors to a specific time period or purpose. Permanently restricted net assets have been restricted by donors to be maintained by the Hospital in perpetuity. Temporarily restricted net assets are restricted primarily for construction, certain departments and other services. Income on permanently restricted net assets is restricted for certain departments and other services. Charity Care The Hospital provides care to patients who meet the strict charity care criteria of the New Jersey State Department of Health (the Department ) without charge or at amounts less than its established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient service revenue. In accordance with guidelines established by the Department, the Hospital maintains records to identify and monitor the level of charity care it provides. The estimated costs of providing charity care are based upon the direct and indirect costs identified with the specific charity care services provided. The level of charity care provided by the Hospital amounted to approximately $25,830 in 2014 and $38,957 in The State provides certain subsidy payments to qualified hospitals to partially fund uncompensated care and certain other costs. Subsidy payments recognized as revenue amounted to approximately $10,256 and $8,478 for 2014 and 2013, respectively, and are included in net patient service revenue. Advertising Costs Advertising costs are expensed as incurred. Such costs amounted to approximately $5,128 in 2014 and $3,905 in

16 Estimated Malpractice Costs The provision for estimated medical malpractice claims includes estimates of the ultimate costs for both reported claims and claims incurred but not reported, including costs associated with litigating or settling claims. Anticipated insurance recoveries associated with reported claims are reported separately in the Hospital s balance sheet at net realizable value. Donor-Restricted Gifts Unconditional promises to give cash and other assets to the Hospital are reported at fair value at the date the promise is received. Conditional promises to give and indications of intentions to give are reported at fair value at the date the gift is received. The gifts are reported as either temporarily or permanently restricted support if they are received with donor stipulations that limit the use of the donated assets. When a donor restriction expires, that is, when a stipulated time restriction ends or purpose restriction is accomplished, temporarily restricted net assets are reclassified as unrestricted net assets and reported in the statements of operations, and changes in net assets, as net assets released from restrictions. Donor-restricted contributions whose restrictions are met within the same year as received are reported as unrestricted gifts and bequests in the accompanying financial statements. Revenues in Excess of Expenses The statements of operations include revenues in excess of expenses. Changes in unrestricted net assets which are excluded from revenues in excess of expenses, consistent with industry practice, include change in net unrealized gains and losses on investments other than trading, permanent transfers of assets to and from affiliates for other than goods and services, and contributions and grants of long-lived assets (including assets acquired using contributions which by donor restriction were to be used for the purposes of acquiring such assets). Functional Expenses The Hospital provides general health care services to residents within its geographic area. Expenses related to providing these services for the years ended December 31, 2014 and 2013 are as follows: Health care services $ 921,136 $ 758,126 General and administrative 96,448 54,238 Total $ 1,017,584 $ 812,364 14

17 Federal Income Taxes The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code ) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The Hospital is also exempt from state and local taxes. The Hospital follows the provisions of the authoritative guidance on accounting for uncertainty in income taxes. The guidance clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements and prescribes a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold has been met. The guidance also provides guidance on de-recognition, classification, interest and penalties, accounting in interim periods, and disclosure. Management has determined that the guidance did not have a material impact on the financial statements. The Hospital s policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses. The Hospital s federal tax-exempt organization business income tax returns are no longer subject to examination by the Internal Revenue Service for years before Subsequent Events The Hospital evaluated events for recognition or disclosure subsequent to December 31, 2014 and through April 13, 2015, the date on which the financial statements were issued. Reclassification Certain 2013 amounts have been reclassified to conform to the 2014 presentation. 2. New Accounting Standards Services Received from Personnel of an Affiliate In April 2013, the Financial Accounting Standards Board ( FASB ) issued guidance to provide consistency in accounting for shared costs by not-for-profit organizations with multiple affiliates, including health care systems. Under this guidance, direct personnel costs (salaries and wages and payroll-related employee benefits) will be recognized by entities that receive services from affiliates. These costs will be recognized at cost as equity transfers and will be excluded from revenues in excess of expenses. The guidance is effective for periods beginning after June 15, The amended guidance will require prospective adjustment of the statement of changes in net assets and related disclosures. 15

18 3. Acquisition of Somerset Effective June 1, 2014, Somerset was merged into the Hospital in an effort to expand operations into the healthcare market in Somerville, New Jersey. As part of the merger, Somerset dissolved as of June 1, 2014, and transferred its assets and liabilities to the Hospital and the Hospital became the sole member and/or parent corporation of Somerset. In accordance with authoritative guidance, the Hospital recorded the fair value of the assets acquired and liabilities assumed from Somerset as of the acquisition date as follows: May 31, 2014 Assets: Cash and cash equivalents $ 6,773 Investments and assets whose use is limited 28,998 Patients accounts receivable, net 27,933 Other assets 12,392 Property and equipment, net 123,289 Adjustment of property and equipment to fair market value per appraisal 56,361 Total assets acquired 255,746 Liabilities: Long-term debt 2,176 Accounts payable and accrued expenses 19,585 Other liabilities 21,872 Deferred gain on sale of property 4,126 Accrued pension and other liabilities 31,800 Due to the Hospital 90,109 Total liabilities assumed 169,668 Inherent contribution of Somerset Medical Center $ 86,078 The classification of inherent contribution of Somerset Medical Center is as follows: Unrestricted $ 83,157 Temporarily restricted 1,781 Permanently restricted 1,140 Total inherent contribution of Somerset Medical Center $ 86,078 16

19 On May 30, 2014, Somerset received funds from the Hospital sufficient to redeem the Series 2003 Bonds and the Series 2008 Bonds. The Hospital funded the redemption of the bonds with a line of credit. The redemption occurred in June Somerset's bond counsel provided Somerset with a legal opinion that the Series 2003 Bonds and the Series 2008 Bonds were considered to be defeased as of May 31, Therefore, Somerset derecognized the Series 2003 Bonds and Series 2008 Bonds as of May 31, 2014 and recorded a due to the Hospital in the amount the Hospital incurred on the line of credit. The Hospital refinanced the amount outstanding on the line of credit by issuing Series 2014 Bonds (Note 5). Beginning June 1, 2014, the operations of Somerset have been reported in the Hospital's statement of operations. In 2014, total unrestricted revenue and other support of $146,791, decrease in unrestricted net assets of $8,642, and increase in temporarily restricted net assets of $1,177 was attributed to the acquisition of Somerset. The following summarized information represents the combined amounts of the Hospital and Somerset as if the acquisition occurred as of January 1, 2013: Total revenue $ 1,150,036 $ 1,089,888 Change in unrestricted net assets $ 47,695 $ 118,330 Change in temporarily restricted net assets $ 5,147 $ 1,935 Change in permanently restricted net assets $ 1,479 $ 36 17

20 4. Property and Equipment The items comprising such accounts as of are summarized as follows: Depreciable assets: Land improvements $ 1,782 $ 441 Buildings 584, ,356 Building service equipment 59,677 57,468 Fixed equipment 54,411 24,423 Major movable equipment 424, ,485 Capitalized leases 10,471 10,471 Total 1,135, ,644 Less accumulated depreciation and amortization (including amortization of capitalized leases of $6,296 and $5,149 as of December 31, 2014 and 2013, respectively) 721, , , ,374 Nondepreciable assets: Land 12,321 7,921 Construction in progress 111,332 51, ,653 59,126 Property and equipment, net $ 537,236 $ 315,500 Construction in progress at December 31, 2014 consists primarily of construction of the Proton Beam Facility and construction costs, development fees, architect fees and other costs related to construction of the East Tower and the South Building Expansion projects ("the Projects"). The estimated costs to complete construction of the Proton Beam Facility and the Projects are $7.7 million and $116.7 million, respectively. 18

21 5. Long-Term Debt A summary of long-term debt as of is as follows: Robert Wood Johnson University Hospital, Series 2003 Revenue Bonds less unamortized bond discount of $15 and $19 as of, respectively $ 9,885 $ 11,881 Robert Wood Johnson University Hospital, Series 2004 Revenue Bonds less unamortized bond discount of $69 and $83 as of, respectively 35,591 37,302 Robert Wood Johnson University Hospital, Series 2010 Revenue Bonds plus unamortized bond premium of $1,925 and $2,136 as of December 31, 2014 and 2013, respectively 114, ,296 Robert Wood Johnson University Hospital, Series 2013 Revenue Bonds less unamortized bond discount and plus premium of $999 and $1,324, respectively, as of December 31, 2014 and less unamortized bond discount and plus premium of $1,324 and $1,397, respectively, as of December 31, , ,521 Robert Wood Johnson University Hospital, Series 2014 Revenue Bonds plus unamortized bond premium of $5,862 as of December 31, ,787 - Capital lease obligations 3,621 4, , ,134 Less current installments 7,773 7,538 Long-term debt, excluding current installments $ 428,391 $ 344,596 19

22 Series 2003 Bonds On June 20, 2003, the New Jersey Healthcare Facilities Financing Authority ( Authority ) issued $25,000 principal amount tax exempt revenue bonds through a variable rate composite program to the Hospital (2003 Bonds). The 2003 Bonds are scheduled to mature on July 1, The Hospital utilized the proceeds of the 2003 Bonds to 1) refund $14,165 in outstanding bonds (New Jersey Health Care Facilities Financing Authority $27,130 Revenue Bonds, Robert Wood Johnson University Hospital Issue, Series B), 2) pay the cost of constructing and equipping an inpatient oncology unit, 3) replace certain elevators, ventilators and information technology hardware and 4) to pay a portion of the related financing costs. The 2003 Bonds are special and limited obligations of the Authority, payable solely from and secured by the revenues and other monies pledged by the Hospital pursuant to a Loan Agreement with the Authority and a Reimbursement Agreement with the trustee bank. The 2003 Bonds are also collateralized by a $20,463 unsecured irrevocable letter of credit which is financed by the Hospital and held by, and for the benefit of, the bond trustee. The letter of credit expires on September 30, 2018 and must be renewed and maintained throughout the life of the 2003 Bonds. The 2003 Bonds initially bore interest at a weekly variable rate and are subject to conversion to a term rate (.01% at December 31, 2014). The maximum rate of interest on the bonds is 12% per annum. Series 2004 Bonds On September 22, 2004, the Authority issued $50,000 principal amount variable rate tax exempt revenue bonds, Robert Wood Johnson University Hospital Issue, Series 2004 (Series 2004 Bonds), pursuant to the Authority s General Health Care Facilities Bond Resolution. The proceeds received from the Series 2004 Bonds were utilized to provide for constructing and equipping a three story vertical expansion of the Bristol Myers Squibb Children s Hospital at Robert Wood Johnson University Hospital and renovating and equipping obstetrics space in adjacent Hospital buildings. A portion of the bond proceeds was also used to enhance pediatric special procedure and surgical facilities as well as to pay for financing and issuance costs. The 2004 Bonds are scheduled to mature on July 1, The Series 2004 Bonds are special and limited obligations of the Authority, payable solely from and secured by revenues and other monies pledged by the Hospital pursuant to a Loan Agreement with the Authority and a Reimbursement Agreement with the trustee. The Series 2004 Bonds are also fully collateralized by a $45,900 unsecured irrevocable letter of credit which is financed by the Hospital and held by, and for the benefit of, the bond trustee. The letter of credit expires on September 30, 2018 and must be renewed and maintained throughout the life of the Series 2004 Bonds. The Series 2004 Bonds initially bore interest at a variable weekly rate and are subject to conversion to a term bond at a maximum annual interest rate of 12% (.01% at December 31, 2014). 20

23 Series 2010 Bonds On September 9, 2010, the Authority issued $126,415 principal amount of Revenue Bonds, Robert Wood Johnson University Hospital Issue, Series 2010 (Series 2010 bonds), pursuant to the Authority s General Health Care Facilities Registered Bond Resolution. The proceeds received from the Series 2010 bonds were utilized for the current refunding of the Series 2000 bonds in the amount of $126,640 resulting in a loss on the defeasance of debt in the amount of $2,840 which is recorded in the 2010 statement of operations. In addition, the proceeds were used to establish a debt service reserve fund, to pay certain costs incidental to the issuance and sale of the Series 2010 bonds. Monthly payments must be made to the trustee in amounts sufficient to pay interest to the bondholders. The Hospital is required to pay to the trustee monthly amounts for a debt service fund. This fund will be used by the trustee to make payments toward debt service and to provide a fund sufficient to retire the total debt. The Hospital is required to maintain debt service reserve funds for the Series 2010 bonds in an amount equal to the maximum annual debt service. The Series 2010 Bond Issue includes serial bonds aggregating $55,795 which mature in annual amounts between 2011 and 2022 and bear interest at varying rates from 2.0% to 5.0%. The Series 2010 bonds also include two term bonds aggregating $70,620, which are due in 2025 and 2031, and which bear interest at rates of 4.38% and 5.00%, respectively. The Series 2000 bonds maturing on or after July 1, 2021 are subject to redemption prior to maturity. Series 2013 Bonds In September 2013, the Authority issued $180,175 principal amount of tax exempt revenue bonds, Robert Wood Johnson University Hospital Issue, Series 2013A and Series 2013B bonds (Series 2013 Bonds), pursuant to the Authority s General Health Care Facilities Registered Bond Resolution. The proceeds received from the Series 2013 Bonds will be used to provide for constructing a parking and office facility, constructing and/or renovating the expansion of patient floors and four new operating rooms. The Series 2013A Bonds are fixed rate bonds issued for $110,175. These bonds include serial bonds aggregating $16,890, which mature in annual amounts between 2016 and 2023 and bear interest at varying rates from 3.0% to 5.0%. The Series 2013A bonds also include three term bonds aggregating $93,285, which are due in 2028, 2035, and 2043 and which bear interest at varying rates from 5.25% to 5.50%. The 2013A Bonds are scheduled to mature on July 1,

24 The Series 2013B Bonds are variable rate bonds issued in the amount of $70,000. These bonds are special and limited obligations of the Authority, payable solely from and secured by revenues and other monies pledged by the Hospital pursuant to a Loan Agreement with the Authority and a Reimbursement Agreement with the trustee. The Series 2013B Bonds are also fully collateralized by a $70,000 unsecured irrevocable letter of credit which is financed by the Hospital and held by, and for the benefit of, the bond trustee. The letter of credit expires on September 30, 2018 and must be renewed and maintained throughout the life of the Series 2013B Bonds. The 2013B Bonds are scheduled to mature on July 1, The Series 2013B Bonds initially bore interest at a variable weekly rate and are subject to conversion to a term bond at a maximum annual interest rate of 12% (.02% at December 31, 2014). Series 2014 Bonds In September 2014, the Authority issued $85,925 principal amount of tax exempt revenue bonds, Robert Wood Johnson University Hospital Issue, Series 2014A and Series 2014B bonds (Series 2014 Bonds) with an original issue premium of $5,940. The proceeds received from the Series 2014 Bonds were used to repay the line of credit taken out in order to pay off Somerset Medical Center's Series 2003 and Series 2008 Bonds (Note 3). The Series 2014A Bonds are fixed rate bonds issued for $55,925. These bonds include serial bonds aggregating $11,075, which mature in annual amounts between 2032 and 2034 and bear interest of 5.0%. These bonds also include two term bonds for $22,480, due July 1, 2039 and $22,370, due July 1, 2043 and bear interest of 5.0%. The Series 2014B Bonds are variable rate bonds issued in the amount of $30,000. These bonds are special and limited obligations of the Authority, payable solely from and secured by revenues and other monies pledged by the Hospital pursuant to a Loan Agreement with the Authority and a Reimbursement Agreement with the trustee. The Series 2014B Bonds are also fully collateralized by a $30,000 unsecured irrevocable letter of credit which is financed by the Hospital and held by, and for the benefit of, the bond trustee. The letter of credit expires on September 8, 2017 and must be renewed and maintained throughout the life of the Series 2014B Bonds. The 2014B Bonds are scheduled to mature on July 1, The Series 2014B Bonds initially bore interest at a variable weekly rate and are subject to conversion to a term bond at a maximum annual interest rate of 12% (.04% at December 31, 2014). 22

25 Sinking Fund Requirements Amounts anticipated to be deposited in the debt service funds for the purpose of paying the principal on the Series 2003, Series 2004, Series 2010, Series 2013 and Series 2014 bonds over the next five years and thereafter are as follows as of December 31, 2014: Series 2003 Principal Sinking Fund Requirements Series 2004 Principal Sinking Fund Requirements Series 2010 Principal Sinking Fund Requirements Series 2013 Principal Sinking Fund Requirements Series 2014 Principal Sinking Fund Requirements Total Principal Requirements 2015 $ 1,900 $ 1,790 $ 3,550 $ - $ - $ 7, ,860 4,850 1,815-9, ,935 5,075 1,865-9, ,010 5,280 1,940-10, ,000 2,090 5,500 2,040-10,630 Thereafter 4,300 25,975 88, ,515 85, ,315 Total $ 9,900 $ 35,660 $ 112,855 $ 180,175 $ 85,925 $ 424,515 The debt agreements of the above bonds require the Hospital to meet certain financial covenants and ratios. Capital Lease Obligations The Housing and Urban Development Authority of the City of New Brunswick (the Development Authority) issued $55,295 principal amount of Lease Revenue Bonds, Series 1993 in connection with a redevelopment project consisting of the construction of a combined use structure which includes, among other things, a 959 unit parking deck (the Project). The Development Authority appointed Rutgers as developer of the Project. On July 23, 1992, the Hospital, Rutgers and the Development Authority entered into a three way participation agreement whereby the Hospital agreed to sublet from Rutgers a portion of the Project consisting of 600 parking spaces together with the common space within the Project applicable thereto for an initial term of five years. The lease includes six separate consecutive options to renew the sublease for five year terms. On December 11, 1998, the Development Authority issued $54,505 principal amount of Housing Authority of the City of New Brunswick Lease Revenue Refunding Bonds, Series The proceeds received from the Series 1998 bonds were utilized to provide financing for the refunding of Series 1993 bonds. On March 25, 2011, the Development Authority issued $31,345 principal amount of Housing Authority of the City of New Brunswick Lease Revenue Refunding Bonds, Series The proceeds received from the Series 2011 bonds were utilized to provide financing for the refunding of Series 1998 bonds. The lease is now payable through July 1,

26 The following is a schedule of future minimum lease payments subsequent to December 31, 2014: 2015 $ Thereafter 719 Total minimum payments 4,314 Less amounts representing interest 693 3,621 Less current installments Retirement Plans Total $ 3,088 Defined Benefit Pension Plan As of June 1, 2014, the Hospital assumed a noncontributory defined benefit pension plan (the Plan ) covering all eligible employees as part of the Somerset acquisition. The Hospital s policy is to make contributions sufficient to meet the minimum funding requirements of the Employee Retirement Income Security Act of Effective January 1, 2002, the Somerset Board of Trustees approved the freezing of all benefit accruals under the defined benefit pension plan. 24

27 The following table provides a reconciliation of benefit obligations, plan assets, funding status, amounts recognized in the Hospital's financial statements for the year ended December 31, 2014 as follows: 2014 Change in benefit obligation: Benefit obligation, beginning of year $ - Benefit obligation assumed from Somerset Medical Center 90,787 Interest cost 2,085 Actuarial loss (gain) 11,765 Benefits paid (2,489) Benefit obligation, end of year 102,148 Change in plan assets: Fair value of plan assets - beginning of year $ - Fair value of plan assets acquired 71,037 Actual return on plan assets 1,511 Employer contributions 1,385 Expenses (439) Benefits paid (2,489) Fair value of plan assets, end of year 71,005 Funded status $ (31,143) Accumulated benefit obligation $ 102,148 Components of net periodic pension cost: 2014 Interest cost $ 2,085 Service cost 299 Expected return on plan assets (2,766) Total net periodic pension cost $ (382) The contribution to the Plan for calendar year 2015 is expected to be approximately $4,855. At December 31, 2014, $31,143 of accrued pension cost is recorded in other long-term liabilities in the balance sheet. 25

28 A net loss of $13,160 represents the unrecognized component of net periodic benefit cost included in unrestricted net assets at December 31, The weighted-average assumptions used in computing the Plan s benefit obligation at December 31, 2014: Discount rate 3.75 % The weighted-average assumptions used in the measurement of the Plan s net periodic pension cost for the year ended December 31, 2014: Discount rate 3.75 % Expected long-term rate of return on plan assets 6.25 % The expected long-term rate of return on plan assets assumption was developed based on historical returns for the major asset classes. This review also considered both current market conditions and projected future conditions. Adjustments are made to the expected long-term rate of return assumption when deemed necessary based upon revised expectations of future investment performance of the overall capital markets. The following table sets forth the actual asset allocation and target asset allocation for plan assets at December 31, 2014: Target Asset 2014 Allocation Asset category: Equity securities 33 % % Fixed income 46 % % Alternative investments 15 % 0-20 % Cash equivalents 6 % 0-20 % The plan assets are invested among and within various asset classes in order to achieve sufficient diversification in accordance with the Hospital s risk tolerance. This is achieved through the utilization of asset managers and systemic allocation to investment management styles, providing a broad exposure to different segments of the fixed income and equity markets. 26

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